4A (Expenses $ 1174472202 including grants of $ 1986824) (Revenue $ 1444050291)
Operation of 5 acute care hospitals with 32,748 patient admissions, 150,399 patient days and 299,607 outpatient visits in the current year. In addition to hospital operations, the corporation provides medical care through a number of other activities such as urgent care centers, physician clinics, home health services, hospice services, sleep centers, wound centers, therapy and rehab.

Part V, Section B
Facility Reporting Group A

Facility Reporting Group A consists of:
- Facility 1: Porter Adventist Hospital, - Facility 2: Parker Adventist Hospital, - Facility 3: Littleton Adventist Hospital, - Facility 4: Castle Rock Adventist Health Campus, - Facility 5: Avista Adventist Hospital

Facility Reporting Group A Part V, Section B, line 5:
In order to assess the needs of the community while conducting its fiscal year 2022 Community Health Needs Assessment (CHNA), the Hospitals received input from community-based organizations focused on health and social determinants of health regarding medically underserved, low-income and minority populations in the service area. Each Hospital conducted Community Health Needs Assessment Advisory Subcommittee meetings with community-based organizations in their respective communities. Organizations were identified based upon their connection with the community, including those serving people who are medically underserved and at greater risk of poor health and those organizations with influence on overall health in the community. Stakeholders provided input in multiple meetings to rank and prioritize health issues, identify both community assets and gaps, and to identify strategies for the health priorities. Lastly, the Hospitals engaged in the local County Health Departments and the Hospital Transformation Program Community and Health Neighborhood Engagement process focusing on the Medicaid population through which both community and Medicaid data were analyzed and focus groups were conducted.

Schedule H, Part V, Section B, Line 7a, Hospital Facility CHNA Website
Facility 1 - Parker Adventist Hospitalhttps://www.centura.org/community-impact/community-benefitFacility 2 - Porter Adventist Hospitalhttps://www.centura.org/community-impact/community-benefitFacility 3 - Littleton Adventist Hospitalhttps://www.centura.org/community-impact/community-benefitFacility 4 - Castle Rock Adentist Health Campushttps://www.centura.org/community-impact/community-benefitFacility 5 - Avista Adventist Hospitalhttps://www.centura.org/community-impact/community-benefit

Schedule H, Part V, Section B, Line 10:
Each hospital facility's most recently adopted implementation strategy was made widely available through the following websites:Facility 1 - Parker Adventist Hospitalhttps://www.centura.org/community-impact/community-benefitFacility 2 - Porter Adventist Hospitalhttps://www.centura.org/community-impact/community-benefitFacility 3 - Littleton Adventist Hospitalhttps://www.centura.org/community-impact/community-benefitFacility 4 - Castle Rock Adentist Health Campushttps://www.centura.org/community-impact/community-benefitFacility 5 - Avista Adventist Hospitalhttps://www.centura.org/community-impact/community-benefit

Schedule H, Part V, Section B, Line 16a - c:
Each hospital facility's FAP, FAP application form and plain language summary of the FAP was made widely available through the following websites:Facility 1 - Parker Adventist Hospitalhttps://www.centura.org/patient-tools/billing-and-financial-services/financial-helpFacility 2 - Porter Adventist Hospitalhttps://www.centura.org/patient-tools/billing-and-financial-services/financial-helpFactility 3 - Littleton Adventist Hospitalhttps://www.centura.org/patient-tools/billing-and-financial-services/financial-helpFacility 4 - Castle Rock Adventist Health Campushttps://www.centura.org/patient-tools/billing-and-financial-services/financial-helpFacility 5 - Avista Adventist Hospitalhttps://www.centura.org/patient-tools/billing-and-financial-services/financial-help

Schedule H, Part V, Section B, Line 11:
The information provided below explains how each Hospital facility addressed in fiscal year 2022 (year ended June 30, 2022) the significant health needs identified in its fiscal year 2019 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. This is the third-year update for the filing organization's fiscal year 2020-2022 Community Health Implementation Plan. The filing organization developed this Plan and posted it by November 15, 2019 as part of its fiscal year 2020 Community Health Needs Assessment process. The following narrative describes the issues identified in fiscal year 2019 by each Hospital facility and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the facilities are not addressing.Facility 1 - Porter Adventist HospitalPorter Adventist Hospital (PAH) conducted its FY 2019 Community Health Needs Assessment (CHNA) through a collaborative partnership with Parker Adventist Hospital, Castle Rock Adventist Hospital, Littleton Adventist Hospital, and the Denver and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data was gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with PAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Behavioral Health, and Access to Healthy Affordable Food. PAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified. During fiscal year 2022, the following actions were taken with respect to the Behavioral Health initiative. PAH implemented the Zero Suicide Framework, a best practice to screen for risk of suicide attempt and refer people to resources. The Alternatives to Opioids (ALTO) program is being conducted by PAH to help prevent opioid addiction. PAHS participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. With respect to the prioritized need of Access to Healthy Affordable Food, PAH partnered to support SNAP Outreach during the pandemic in multiple languages . The hospital also screened 61 households for food security and enrolled 9 families into public assistance programs such as SNAP, WIC and other food assistance programs. PAH partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership to increase the number of stores accepting SNAP/WIC in communities. PAH did not address the following identified health issues due to limited resources and the availability of other community organizations to address such needs: Heart Disease, Diabetes, Overweight/Obesity and Physical Activity/Nutrition, Intentional Injury, Asthma, and Substance Abuse. See Continuation

Schedule H, Part V, Section B, Line 11: - continuation
Facility 2 - Parker Adventist Hospital Parker Adventist Hospital (PKAH) conducted its FY 2019 Community Health Needs Assessment (CHNA) through a collaborative partnership with Porter Adventist Hospital, Castle Rock Adventist Hospital, Littleton Adventist Hospital, and the Denver and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data was gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with PKAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Behavioral Health and Access to Healthy Affordable Food. PKAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified. During fiscal year 2022, the following actions were taken with respect to the Behavioral Health initiative. PKAH implemented the Zero Suicide Framework, a best practice to screen for risk of suicide attempt and referring people to resources. The Alternatives to Opioids (ALTO) program is being conducted by PKAH to help prevent opioid addiction. PAHS participates in The Let's Talk Campaign, done in partnership with other organizations in the community, to reduce stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. Additionally, PKAH provided funding to a local school district to support a Community of Practice mental health program which focused on educating principals, teachers and other administrators on stigma campaigns. With respect to the prioritized need of Access to Healthy Affordable Food, PKAH supported SNAP Outreach through a community organization in multiple languages. The hospital also screened 152 households for food security and enrolled 18 families into public assistance programs such as SNAP, WIC and other food assistance programs. PKAH partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and to increase the number of businesses offering the program. We also established a partnership to increase the number of stores accepting SNAP/WIC in communities. PKAH also partnered with a local food pantry to increase the amount of food available to community members and to develop a system to track the services. PKAH did not address the following identified health issues due to limited resources and the availability of other community organizations to address such needs: Heart Disease, Diabetes, Overweight/Obesity and Physical Activity/Nutrition, Intentional Injury, Asthma, and Substance Abuse. Facility 3 - Littleton Adventist HospitalLittleton Adventist Hospital (LAH) conducted its FY 2019 Community Health Needs Assessment (CHNA) through a collaborative partnership with Parker Adventist Hospital, Castle Rock Adventist Hospital, Porter Adventist Hospital, and the Denver and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data was gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with LAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Behavioral Health, and Access to Healthy Affordable Food. LAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified. During fiscal year 2022, the following actions were taken with respect to the Behavioral Health initiative. LAH implemented the Zero Suicide Framework, a best practice to screen for risk of suicide attempt and refer people to resources. The Alternatives to Opioids (ALTO) program is being conducted by LAH to help prevent opioid addiction. PAHS participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce stigma associated with mental health, and has established partnerships with other community-based organizations that reach black and LatinX communities. With respect to the prioritized need of Access to Healthy Affordable Food, LAH partnered to support SNAP Outreach during the pandemic in multiple languages. The Hospital also screened 29 households for food security and enrolled 5 families into public assistance programs such as SNAP, WIC and other food assistance programs. LAH partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership to increase the number of stores accepting SNAP/WIC in communities. LAH did not address the following identified health issues due to limited resources and the availability of other community organizations to address such needs: Heart Disease, Diabetes, Overweight/Obesity and Physical Activity/Nutrition, Intentional Injury, Asthma, and Substance Abuse.

Schedule H, Part V, Section B, Line 11: - continuation
Facility 4 - Castle Rock Adventist HospitalCastle Rock Adventist Hospital (CRAH) conducted its FY 2019 Community Health Needs Assessment (CHNA) through a collaborative partnership with Parker Adventist Hospital, Porter Adventist Hospital, Littleton Adventist Hospital, and the Denver and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data was gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with CRAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Behavioral Health, and Access to Healthy Affordable Food. CRAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified. During fiscal year 2022, the following actions were taken with respect to the Behavioral Health initiative. CRAH implemented the Zero Suicide Framework, a best practice to screen for risk of suicide attempt and refer people to resources. The Alternatives to Opioids (ALTO) program is being conducted by CRAH to help prevent opioid addiction. PAHS participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. With respect to the prioritized need of Access to Healthy Affordable Food, CRAH partnered to conduct SNAP Outreach during the pandemic in multiple languages. The Hospital also screened 99 households and enrolled 16 families into public assistance programs, including SNAP/WIC and other food assistance programs. CRAH partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership to increase the number of stores accepting SNAP/WIC in communities.CRAH did not address the following identified health issues due to limited resources and the availability of other community organizations to address such needs: Heart Disease, Diabetes, Overweight/Obesity and Physical Activity/Nutrition, Intentional Injury, Asthma, and Substance Abuse.Facility 5 - Avista Adventist HospitalAvista Adventist Hospital (AAH) conducted its FY 2019 Community Health Needs Assessment (CHNA) through a collaborative partnership with the Boulder County Public Health Department, Broomfield Public Health, and community stakeholders. Both qualitative and quantitative primary and secondary data was gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with AAH and community existing efforts. Total scores were compiled and resulted in the identification of the following prioritized health issues: Behavioral Health, and Access to Safe, Affordable Housing/Shelter/Food. AAH recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified. During fiscal year 2022, the following actions were taken with respect to the Behavioral Health initiative. AAH implemented the Zero Suicide Framework, a best practice to screen for risk of suicide attempt and refer people to resources. The Alternatives to Opioids (ALTO) program is being conducted by AAH to help prevent opioid addiction. PAHS participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. With respect to the prioritized need of Access to Safe, Affordable Housing/Shelter, we are working to integrate screenings for housing instability and referrals to available resources into a patient's Electronic Health Record. For Access to Healthy Affordable Food, AAH partnered to support SNAP Outreach during the pandemic in multiple languages. The Hospital also screened 57 households and enrolled 11 families into public assistance programs, including SNAP/WIC and other food assistance programs. AAH partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership to increase the number of stores accepting SNAP/WIC in communities. AAH did not address the identified health issues of Access to Care, Cancer, and Heart Health due to limited resources and other organizations that address these needs.

Part I, Line 6a:
The filing organization operates as a part of Centura Health Corporation (Centura), a joint operating company that integrally manages a number of hospital and other healthcare provider facilities. All hospital organizations within Centura collect, calculate, and report the community benefits they provide to the communities they serve. Centura organizations exist solely to improve and enhance the local communities they serve. Centura has a system-wide community benefits accounting policy that provides guidelines for its health care provider organizations to capture and report the costs of services provided to the underprivileged and to the broader community. Each Centura hospital facility reports their community benefits to their Board of Directors and strives to communicate their community benefits to their local communities. Additionally, the filing organization's most recently conducted community health needs assessment and associated implementation strategy are posted on the filing organization's website.

Part I, Line 7:
Portercare Adventist Health System does not use a cost accounting system to determine the cost of charity care. The estimated cost of care is calculated as the ratio of each facility's total expenses to total gross revenue. Worksheet 2 was not used to develop the cost to charge ratio. There are no physician clinics included in subsidized health services.

Part II, Community Building Activities:
The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with providing education for the filing organization's staff physicians and employees. The filing organization's provision of these educational programs/activities to staff physicians and employees provides an opportunity for health care professionals to enhance their skills and expertise and keep up-to-date with the latest advancements in medical procedures and technology. In addition, training opportunities are often provided on-site at the filing organization's hospital facilities, thereby allowing for health care professionals to be more readily available to assist in meeting immediate patient care needs. Education and training provided to each facility's workforce is vital in assisting health care professionals directly involved in patient care with keeping abreast of the latest developments in their respective areas of expertise, learning possible new and innovative ways of delivering care to patients, and understanding the newest technologies available for the treatment of patients.

Part III, Line 2:
Portercare Adventist Health System (PAHS) uses the overall cost to gross charge ratio applicable to each facility to determine the costs in Part III Lines 2 and 3. PAHS automatically discounts all self pay patient accounts by 30% and also offers a prompt pay discount. This allowance is not included in the calculation of the cost of bad debts in instances where a patient does not pay his or her bill.

Part III, Line 3:
Portercare Adventist Health System does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care. Rationale for Including Certain Bad Debts in Community Benefit:The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains 24/7 emergency rooms providing care to all whom present. When a patient's arrival and/or admission to a facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of 24/7 Emergency Departments that accept all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Departments is a community benefit. Under the filing organization's Financial Assistance Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for financial assistance. However, not all patients will cooperate with such efforts and a financial assistance eligibility determination cannot be made based upon information supplied by the individual. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency Departments should be considered community benefit as charitable hospitals exist to provide such care in pursuit of their purpose of meeting the need for emergency medical care services available to all in the community.

Part III, Line 4:
The financial information of the filing organization is included in a consolidated audited financial statement for the current year.The applicable footnote from the attached consolidated audited financial statements that addresses accounts receivable, the allowance for uncollectible accounts, and the provision for bad debts can be found on pages 8-9. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands.

Part VI, Line 7, Reports Filed With States
CO

Part III, Line 8:
Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio.Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government.

Part III, Line 9b:
The hospital filing organization's collection practices are in conformity with the requirements set forth in the 2014 Final Regulations regarding the requirements of Internal Revenue Code Section 501(r)(4) - (r)(6). No extraordinary collection actions (ECA's) are initiated by the hospital filing organization in the 120-day period following the date after the first post-discharge billing statement is sent to the individual (or, if later, the specified deadline given in a written notice of actions that may be taken, as described below). Individuals are provided with at least one written notice (notice of actions that may be taken) and a copy of the filing organization's Plain Language Summary of the Financial Assistance Policy that informs the individual that the hospital filing organization may take actions to report adverse information to credit reporting agencies/bureaus if the individual does not submit a Financial Assistance Application Form (FAA Form) or pay the amount due by a specified deadline. The specified deadline is not earlier than 120 days after the first post-discharge billing statement is sent to the individual and is at least 30 days after the notice is provided. A reasonable attempt is also made to orally notify an individual about the filing organization's Financial Assistance Policy and how the individual may obtain assistance with the Financial Assistance application process. If an individual submits an incomplete FAA Form during the 240-day period following the date on which the first post-discharge billing statement was sent to the individual, the hospital filing organization suspends any reporting to consumer credit reporting agencies/bureaus (or ceases any other ECA's) and provides a written notice to the individual describing what additional information or documentation is needed to complete the FAA Form. This written notice contains contact information including the telephone number and physical location of each hospital facility's office or department that can provide information about the Financial Assistance Policy, as well as contact information of each hospital facility's office or department that can provide assistance with the financial assistance application process or, alternatively, a nonprofit organization or governmental agency that can provide assistance with the financial assistance application process if the hospital facility is unable to do so. If an individual submits a complete FAA Form within a reasonable time-period as set forth in the notice described above, the hospital filing organization will suspend any adverse reporting to consumer credit reporting agencies/bureaus until a financial assistance policy eligibility determination can be made.

Supplemental Schedule to Schedule H, Part III, Section B, Line 8:
Reconciliation of Schedule H Reported Medicare Surplus/(Shortfall) to Unreimbursed Medicare Costs Associated with the Provision of ServicesTo All Medicare Beneficiaries:The Medicare revenue and allowable costs of care reported in Section B of Part III of Schedule H are based upon the amounts reported in the filing organization's Medicare cost report in accordance with the IRS instructions for Schedule H. On an annual basis, the filing organization also determines its total unreimbursed costs associated with providing services to all Medicare patients. Unreimbursed costs are considered a community benefit to the elderly and are combined into an annual Community Benefit Statement. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to all Medicare patients are as follows:- Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $ (22,955,872)- Difference in costing methodology: (28,840,944)- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (64,514,233) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $ (116,311,049)As indicated above, the primary differences between the Medicare surplus/(shortfall) reported on Schedule H, Part III, Section B, line 7 and the filing organization's annual community benefit statement is due to a difference in the costing methodology and differences in the population of Medicare patients within the calculation. The cost methodology utilized in calculating any Medicare surplus/(shortfall) for purposes of the annual community benefit reporting is based upon the cost-to-charge ratio outlined in Worksheet 2 of the Schedule H instructions. The same cost-to-charge ratio is used to determine the costs associated with services provided to charity care patients and Medicaid patients as reported in Schedule H, Part I, line 7. In addition, the Medicare cost report excludes services provided to Medicare patients for physician services, services provided to patients enrolled in Medicare HMOs, and certain services provided by outpatient departments of the filing organization that are reimbursed on a fee schedule. The Company's own community benefit statement captures the unreimbursed cost of providing services to all Medicare beneficiaries throughout the organization.

Part VI, Line 2:
The hospitals provide several services and resources to the communities they serve beyond the prioritized needs specifically identified in the Community Needs Assessment. They sponsor wellness events such as breast feeding education, asthma screenings, and financially support wellness initiatives of cities and public schools. They also provide transportation for low income patients and housing at no cost or very low cost for the families of low income patients of the hospitals that are far from their residence. They also support, financially and through volunteerism, initiatives such as soup kitchens and Meals on Wheels to provide food and nutrition education to address hunger issues. Hospital staff also volunteer to serve as preceptors for students of local health professional programs and serve on boards of local community organizations that provide social services to populations in need.

Part VI, Line 3:
The Financial Assistance Policy (FAP), Financial Assistance Application Form (FAA Form), and the Plain Language Summary of the Financial Assistance Policy (PLS) of the filing organization's hospital facilities are transparent and available to all individuals served at any point in the care continuum. The FAP, FAA Form, PLS, and contact information for each hospital facility's financial counselors are prominently and conspicuously posted on each filing organization's hospital facility's website. The websites indicate that a copy of the FAP, FAA Form, and PLS is available and how to obtain such copies in the primary languages of any populations with limited proficiency in English that constitute the lesser of 1,000 individuals or 5% of the members of the community served by each hospital facility (referred to below as LEP defined populations). Signage is displayed in public locations of each filing organization's hospital facility, including at all points of admission and registration and the Emergency Department. The signage contains each hospital facility's website address where the FAP, FAA Form, and PLS can be accessed and the telephone number and physical location that individuals can call or visit to obtain copies of the FAP, FAA Form and PLS or to obtain more information about the hospital facility's FAP, FAA Form and PLS. Paper copies of the hospital facility's FAP, FAA Form and PLS are available upon request and without charge, both in public locations in the hospital facility and by mail. Paper copies are made available in English and in the primary languages of any LEP defined populations. Each of the filing organization's hospital facility's financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facility who are classified as self-pay during the course of their hospital stay or at time of discharge to explain the FAP and FAA Form and to provide information concerning other sources of assistance that may be available, such as Medicaid. A paper copy of each hospital facility's PLS will be offered to every patient as a part of the intake or discharge process. A conspicuous written notice is included on all billing statements sent to patients that notifies and informs recipients about the availability of financial assistance under the filing organization's financial assistance policy, including the following: 1) the telephone number of the hospital facility's office or department that can provide information about the FAP and the FAA Form; and 2) the website address where copies of the FAP, FAA Form and PLS may be obtained. Reasonable attempts are made to inform individuals about the hospital facility's FAP in all oral communications regarding the amount due for the individual's care. Copies of the PLS are distributed to members of the community in a manner reasonably calculated to reach those members of the community who are most likely to require financial assistance.

Part VI, Line 4:
Littleton Adventist HospitalTo understand the profile of Littleton Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 66% white, 7.1% black, 5.9% Asian, 0.4% Native American/Alaskan Native, 0.2% native Hawaiian/Pacific Islander, 17.4% some other race, and 3% multiple races.- Enthnicity: 17.3% Hispanic or Latino.Approximately 49% of the Hospital's patients during the tax year were Medicare patients, about 12.1% were Medicaid patients, about 3.5% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 64.6% of the hospital's in-patients were admitted through the hospital's Emergency Department.Porter Adventist HospitalTo understand the profile of Porter Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 53.1% white, 10.4% black, 5.3% Asian, .5% Native American/Alaskan Native, .2% native Hawaiian/Pacific Islander, 27.3% some other race, and 3.1% multiple races. - Ethnicity: 27.1% Hispanic or Latino.Approximately 47.1% of the Hospital's patients during the tax year were Medicare patients, about 15.6% were Medicaid patients, about 4.3% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 54% of the hospital's in-patients were admitted through the hospital's Emergency Department.Parker Adventist HospitalTo understand the profile of Parker Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 66% white, 7.1% black, 5.9% Asian, 0.4% Native American/Alaskan Native, 0.2% native Hawaiian/Pacific Islander, 17.4% some other race, and 3% multiple races.- Ethnicity: 17.3% Hispanic or Latino.Approximately 40.1% of the Hospital's patients during the tax year were Medicare patients, about 14.4% were Medicaid patients, about 3.1% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 64.3% of the hospital's in-patients were admitted through the hospital's Emergency Department.Avista Adventist HospitalTo understand the profile of Avista Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 76.9% white, 1% black, 5.1% Asian, 0.4% Native American/Alaskan Native, 0.1% Native Hawaiian/Pacific Islander, 14.3% some other race, and 2.4% multiple races. - Ethnicity: 14.1% Hispanic or LatinoApproximately 32.7% of the Hospital's patients during the tax year were Medicare patients, about 16.6% were Medicaid patients, about 7.3% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 23.5% of the hospital's in-patients were admitted through the hospital's Emergency Department.Castle Rock Adventist HospitalTo understand the profile of Castle Rock Adventist Health Campus's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 82% white, 1.3% black, 4.9% Asian, 0.3% Native American/Alaskan Native, 0.1% native Hawaiian/Pacific Islander, 9% some other race, and 2.4% multiple races.- Ethnicity: 8.9% Hispanic or Latino. Approximately 35.9% of the Hospital's patients during the tax year were Medicare patients, about 13.2% were Medicaid patients, about 5.6% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 58.7% of the hospital's in-patients were admitted through the hospital's Emergency Department.

Part VI, Line 5:
"The provision of community benefit is central to Portercare Adventist Health System's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of ""extending the healing ministry of Christ by caring for those who are ill and by nuturing the health of the people in our communities and embodies the filing organization's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit and community building information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $1,408,472 of benefit with respect to the faith-based and spiritual needs of its communities in conjunction with its operation of community hospitals. The filing organization also provides benefits to each of its community's infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care to the community. During the current year, the filing organization expended $56,473,936 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the filing organization are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities."

Part VI, Line 6:
"Portercare Adventist Health System is operated as part of Centura Health Corporation (""Centura""). Centura and its affiliated organizations are dedicated to extending the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities. Specifically, Centura has launched a system-wide strategic plan to improve the quality, consistency, availability, and affordability of health care to communities throughout Colorado. The three main components of this strategy are (1) to continue investing in technology advancements that improve the quality, costs, and coordination of care including the establishment of electronic health records linking our physicians, clinics, hospitals, long-term facilities and home care services; (2) providing wellness care, thereby potentially reducing health care costs by helping patients to maintain good health, growing the level of support and outreach provided to rural communities, and increasing access, affordability and quality of health care; and (3) coordinate and develop systems of care, looking to each facility and entity in Centura to share best practices and improve overall efficiency and communication system-wide from birth to home care."